The Prognostic Impact of the Number of Metastatic Lymph Nodes and a New Prognostic Scoring System for Recurrence in Early-Stage Cervical Cancer with High Risk Factors: A Multicenter Cohort Study (KROG 15-04).
The Prognostic Impact of the Number of Metastatic Lymph Nodes and a New Prognostic Scoring System for Recurrence in Early-Stage Cervical Cancer with High Risk Factors: A Multicenter Cohort Study (KROG 15-04).
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DOI：
10.4143/crt.2017.346
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发表时间：
2018-07
影响因子：
4.6
通讯作者：
Cha J
中科院分区：
文献类型：
--
作者：
Kwon J;Eom KY;Kim YS;Park W;Chun M;Lee J;Kim YB;Yoon WS;Kim JH;Choi JH;Chang SK;Jeong BK;Lee SH;Cha J
我们的目的是评估转移性盆腔淋巴结（mPLN）在早期宫颈癌根治术后化疗和放疗的预后价值。此外，我们试图使用复发的预测因子来定义一个高风险组。使用2000年至2010年13家韩国机构的数据进行了一项多中心回顾性研究。共纳入249例具有高危因素的IB-IIA患者。我们评估了无远处转移生存期（DMFS）和无病生存期（DFS）与临床病理因素的关系，包括pN分期、mPLN数量、淋巴结（LN）比率（阳性LN数量/收获LN数量）和mPLN的对数比值（log（阳性LN数量+0.5/阴性LN数量+0.5））。在单变量分析中，组织学（鳞状细胞癌[SqCC] vs.其他）、淋巴管浸润（LVI）、mPLN数量（≤ 3 vs. > 3）、LN比率（≤ 17% vs. > 17%）和mPLN的对数比值（≤ 0.58 vs. > 0.58）是DMFS和DFS的显著决定因素。切缘受累仅影响DFS。在pN 0患者和具有1-3个mPLN的患者之间没有观察到显著的生存差异。多变量分析显示，mPLN > 3、LVI和非SqCC是DMFS（分别为p < 0.001、p=0.020和p=0.031）和DFS（分别为p < 0.001、p=0.017和p=0.001）的不利指标。使用这三个因素的评分系统预测复发风险具有相对较高的一致性指数（DMFS，0.69; DFS，0.71）。早期宫颈癌中mPLN > 3影响DMFS和DFS。使用mPLN> 3、LVI和非SqCC的评分系统可以将具有高危因素的手术切除的早期宫颈癌复发风险组分层。
We aimed to assess prognostic value of metastatic pelvic lymph node (mPLN) in early-stage cervical cancer treated with radical surgery followed by postoperative chemoradiotherapy. Also, we sought to define a high-risk group using prognosticators for recurrence. A multicenter retrospective study was conducted using the data from 13 Korean institutions from 2000 to 2010. A total of 249 IB-IIA patients with high-risk factors were included. We evaluated distant metastasis-free survival (DMFS) and disease-free survival (DFS) in relation to clinicopathologic factors including pNstage, number of mPLN, lymph node (LN)ratio (number of positive LN/number of harvested LN), and log odds of mPLNs (log(number of positive LN+0.5/number of negative LN+0.5)). In univariate analysis, histology (squamous cell carcinoma [SqCC] vs. others), lymphovascular invasion (LVI), number of mPLNs (≤ 3 vs. > 3), LN ratio (≤ 17% vs. > 17%), and log odds of mPLNs (≤ ‒0.58 vs. > ‒0.58) were significant prognosticators for DMFS and DFS. Resection margin involvement only affected DFS. No significant survival difference was observed between pN0 patients and patients with 1-3 mPLNs. Multivariate analysis revealed that mPLN > 3, LVI, and non-SqCC were unfavorable index for both DMFS (p < 0.001, p=0.020, and p=0.031, respectively) and DFS (p < 0.001, p=0.017, and p=0.001, respectively). A scoring system using these three factors predicts risk of recurrence with relatively high concordance index (DMFS, 0.69; DFS, 0.71). mPLN > 3 in early-stage cervical cancer affects DMFS and DFS. A scoring system using mPLNs > 3, LVI, and non-SqCC could stratify risk groups of recurrence in surgically resected early-stage cervix cancer with high-risk factors.
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DOI：
10.1016/j.ijrobp.2013.07.020
发表时间：
2013-11-15
影响因子：
7
作者：
Lee, Hyun Jin;Han, Seungbong;Kim, Joo-Young
通讯作者：
Kim, Joo-Young
影响因子：
50.5
作者：
Morice, P;Piovesan, P;Castaigne, D
通讯作者：
Castaigne, D
DOI：
10.1097/igc.0b013e3182778bcf
发表时间：
2013-01-01
影响因子：
4.8
作者：
Chen, Ying;Zhang, Lei;Hao, Quan
通讯作者：
Hao, Quan
影响因子：
4.7
作者：
Mabuchi, Seiji;Okazawa, Mika;Kimura, Tadashi
通讯作者：
Kimura, Tadashi
影响因子：
168.9
作者：
Landoni, F;Maneo, A;Mangioni, C
通讯作者：
Mangioni, C